Table 3 Comparison of Clinical Officer (C)O work settings

General COs

•Filtering patients see all patients seeking services in the hospital

•Seen to have easy work as clinicians see patients already diagnosed

•Focus either on tuberculosis (TB) or HIV/AIDS

•Refer difficult cases to specialist clinics or to senior clinicians

•Seen to have a lighter workload, thus clinicians working there seen not to be working hard

• Thus, work follows pre-defined job procedures and guidance on performing these is available

•Have little or no autonomy about their work

•Resources always available as externally funded

•Work is done in shifts (morning afternoon or night), with night duties being disliked

•Have motivating working environments as most sites were recently constructed

•Outpatients always has a heavy workload

•Is described to have poor working relationships with other cadres but not in all sites

•Shortages of supplies to do work reported in some sites

Specialist COs

•Resistance to working here resulting in friction with hospital management due to shortage of COs in some sites for outpatients

•See referred and walk-in patients and perform minor and sometimes major procedures;

•Seen to be a place of escape from the heavy workloads and night duties associated with outpatients

•Refer difficult cases to senior clinicians

•Can admit and follow-up patients in inpatient wards

• Have more autonomy to determine work procedures

• Lighter workload compared with outpatient department

•Good working relationships with colleagues